Evidensia Specialistdjursjukhuset Helsingborg.
AniCura Kleintierspezialisten Augsburg.
Tierarztl Prax Ausg K Kleintiere Heimtiere. 2022 Apr;50(2):138-143. doi: 10.1055/a-1811-4052. Epub 2022 May 6.
Sclerosing encapsulating peritonitis is a rare and not well-recognized disease in veterinary medicine. A 14-month-old female intact mixed-breed dog was diagnosed with sclerosing encapsulating peritonitis (SEP) at the age of 5 months after a routine work-up including biopsies from an exploratory laparotomy. Symptomatic treatment with an immunosuppressive dose of prednisolone was started, but dose reduction was unsuccessful. Combined treatment with tamoxifen, a selective estrogen receptor modulator used for its TGF-β1 suppression of fibroblasts was discussed; the owner was informed about the risk for developing a pyometra. About one year later the owner wanted to spay her dog and an ovariectomy was recommended, especially due to the extensive adhesions. A laparoscopic approach was chosen to reduce the amount of intraoperative tissue manipulation and inflammation, as well as to minimize the size of the incision. The dog continues to be doing well one year after surgery and prednisolone could be reduced to a low maintenance dose after surgery; so far, the addition of tamoxifen was not required. In selected cases, laparoscopy appears as a safe alternative in patients with adhesions, but the surgeon should always be prepared to convert in case of impaired vision, especially in the absence of tactile sensation. This case report is the first description of laparoscopy in a dog with SEP. Laparoscopy may serve as an easily accomplished minimally invasive method to diagnose SEP, but further studies are required.
硬化性包裹性腹膜炎是兽医领域一种罕见且尚未被充分认识的疾病。一只 14 月龄的雌性未绝育混种犬,在 5 月龄时接受了常规检查,包括剖腹探查活检,被诊断为硬化性包裹性腹膜炎(SEP)。开始使用免疫抑制剂量的泼尼松龙进行症状治疗,但剂量减少不成功。讨论了联合使用他莫昔芬(一种用于抑制成纤维细胞 TGF-β1 的选择性雌激素受体调节剂)的治疗方案;向主人告知了发生脓性子宫蓄脓的风险。大约一年后,主人想给她的狗做绝育手术,建议进行卵巢切除术,特别是因为有广泛的粘连。选择腹腔镜方法是为了减少术中组织操作和炎症的程度,并将切口的大小最小化。手术后一年,这只狗的情况仍然良好,泼尼松龙的剂量可以减少到低维持剂量;到目前为止,还不需要添加他莫昔芬。在某些情况下,对于有粘连的患者,腹腔镜似乎是一种安全的替代方法,但外科医生应该始终准备好在视野受损的情况下进行转换,尤其是在没有触觉的情况下。本病例报告是首例描述 SEP 犬行腹腔镜手术的病例。腹腔镜检查可能是一种易于操作的微创方法,可用于诊断 SEP,但需要进一步研究。